Some health conditions are harder to talk about than others. Somewhere near the top of that list for many people is constipation.
Everyone has likely had a bout of constipation at some point or another. It’s a common condition resulting from a number of different causes and often goes away on its own or with minimal treatment, but constipation can also be a symptom of a more serious digestive or other health condition.
What Is Constipation?
A person’s bowel movement schedule — how often, how consistent and what time of day — can vary.
Constipation is defined as irregular bowel movements, in frequency and/or in difficulty of passage. But constipation can mean different things to different people.
“One of the things I always seek to understand is what does it mean to you?” says Dr. Jennifer Brull, a family physician in Plainville, Kansas, and a member of the American Academy of Family Physicians board of directors. “Stools may be too hard or too small, difficult to pass or infrequent — less than three times per week. People with constipation may also notice a frequent need to strain and a sense that the bowels are not empty.”
[Read: A Patient’s Guide to Digestive Diseases.]
Symptoms of Constipation
Although you may be focused on an inability to pass stool when you are constipated, there can be other symptoms involved.
Here are some common symptoms of constipation:
— Bloating.
— Feeling as if you haven’t evacuated completely, even after passing stool.
— Feeling like your intestines or rectum are blocked.
— Having an anal fissure (a small tear in the tissue around the anus) or a hemorrhoid, which can occur from straining to pass stool.
— Having hard, dry stool that’s difficult to pass.
— Having fewer than three bowel movements in a week.
— Nausea.
— Seeing blood on toilet paper, which can occur due to hemorrhoids and excessive straining over time.
— Straining to have a bowel movement.
[SEE: 8 Ways to Stay Hydrated Besides Drinking Water.]
What Causes Constipation?
Although constipation is commonly associated with things like not eating enough fiber or not drinking enough liquids, there are actually many potential causes. Common causes of constipation include:
— Not getting enough physical activity, as exercise can help with digestion.
— Diabetes.
— Hypothyroidism, which is when the thyroid gland doesn’t make enough thyroid hormone.
— Irritable bowel syndrome, which can cause constipation, diarrhea or both.
— Medications such as opioids, calcium channel blockers, anti-nausea medications and antidepressants.
— Pregnancy.
— A bowel obstruction, which could be caused by colon cancer or other lesions.
— Pelvic floor dysfunction.
— A spinal cord injury.
Diseases that affect the body’s autonomic nervous system, such as diabetes and multiple sclerosis, can cause constipation due to nerve damage in the digestive tract or slower movement of food within your digestive system.
Natural Laxatives to Stay Regular
There are a few ways you can naturally address constipation and stay regular:
— Drink more water.
— Increase fiber in your daily diet.
— Get regular physical activity.
— Have a morning routine.
Drink more water
One of the most effective natural treatments for constipation is staying hydrated, says Dr. Steven Furr, a family physician in Jackson, Alabama, and a member of the AAFP board of directors. Even if you’re good about drinking water, keep in mind that heat, exercise and illness all can increase your need for water.
The U.S. National Academies of Sciences, Engineering and Medicine recommends about 15.5 cups of fluids daily for males and 11.5 cups daily for females. This can come from both beverages and foods that contain high water content, such as watermelon and cucumbers.
You can also count other beverages toward your fluid intake, just try to avoid drinks that are high in sugar.
One of the quickest ways to tell if you’re staying hydrated is to look at your urine. A clear or pale color is good; a darker color likely means you need more liquids.
Increase fiber in your daily diet
Dietary fiber adds weight and size to the stool and softens it, making it easier to pass. Fiber supplements can be helpful, but diets composed primarily of processed foods tend to be very low in fiber and can contribute to chronic constipation.
The daily recommended amount of fiber varies depending on the source. The AAFP recommends:
— Adult men get at least 38 grams of fiber per day.
— Adult women get at least 25 grams per day.
“U.S. adults tend to eat about half that much right now,” Brull says.
For children, fiber recommendations vary by age, according to the Cleveland Clinic:
— Ages 1 to 3, 19 grams of fiber a day.
— Ages 4 to 8, 25 grams of fiber a day.
— Ages 9 to 13, 26 grams daily for girls and 31 grams daily for boys.
— Ages 14 to 19, 26 grams daily for girls and 38 grams daily for boys.
Some foods that can help get things moving and keep them moving include:
— Apples.
— Beans.
— Bran cereal.
— Kiwis.
— Leafy greens.
— Olive oil.
— Pears.
— Prunes.
Get regular physical activity
Regular exercise is also part of the prescription list to stay regular.
“Exercise helps relieve constipation by lowering the time it takes food to move through the large intestine,” Brull says. “With a shorter transit time, the body can’t absorb as much water from the stool, which makes it softer and easier to pass.”
Federal guidelines recommend 150 minutes of moderate, heart-pumping physical activity each week. That can break down into 30 minutes, five times a week. If needed, you can even break that into 10 minutes of brisk walking after meals.
If you don’t currently exercise, talk to a health care provider to determine if you’re healthy enough to start exercising.
Have a morning routine
The colon naturally has more motility, or movement, in the morning. Taking advantage of that by drinking warm liquids like coffee or warm water with lemon and honey to try and encourage your body to have a regular bowel movement, says Dr. Ekta Gupta, a gastroenterologist and assistant professor of gastroenterology and hepatology at Johns Hopkins University in Baltimore.
Laxatives
Laxative treatments can help movements move along. These treatments come in a variety of types, and all work differently.
Here is some brief information on the different types of laxatives:
— Osmotic laxatives work by drawing water into the bowel.
— Stimulant laxatives work by causing waves of contraction.
— Stool bulking agents try to keep more water in the stool as it passes through the colon. This helps keep stools softer.
— Stool softeners change stool to keep it softer.
— Lubricant laxatives coat stools so they become more slippery. This helps them come out of the body more easily.
There are different kinds of medications, both prescription and over the counter, that can be tried to help you have a bowel movement. Natural over-the-counter options include magnesium (in doses of 350 milligrams or more) and senna.
Magnesium, an osmotic laxative, can be helpful, but — when used in large quantities — it can cause diarrhea, or you can become dependent on it, Gupta says.
Senna is a stimulant laxative that also can be habit forming if used long term. It can also be associated with abdominal cramps or electrolyte imbalances. Electrolytes are substances like sodium and potassium that help the body work as it should.
Laxatives aren’t meant for long-term use, just occasionally. The AAFP recommends using laxatives for a maximum of one week unless your health care provider says otherwise.
In many cases of constipation, drugs aren’t necessary. Natural remedies often do the trick.
When to See a Health Care Provider
Changes such as eating more fiber and getting regular exercise may take time to become habits. Yet over that time, you should start to notice a difference in your ability to stay regular.
“Many patients will do quite well by implementing these changes in their lives,” Brull says.
You should see a health care provider for constipation if you’ve made diet and lifestyle changes but you continue to have constipation problems for more than three weeks. You should also see a provider if you’ve tried over-the-counter medications but they haven’t helped.
Some symptoms that indicate you should see a health care provider sooner rather than later include:
— Blood in the stool.
— A family history of colon cancer.
— A sudden change in bowel habits.
— Severe abdominal pain and bloating.
— Unexplained weight loss.
— Your stools are black.
A health care provider will take a medical history from you and perform a physical exam, including a rectal exam, Gupta says. Other tests they may perform include:
— An abdominal X-ray.
— An anorectal function test, which involves using a small tube in the rectum and tracking how the muscles around it are used. This can be useful to check for pelvic floor dysfunction.
— Colon transit evaluation, to track how long it takes stool to move through the colon.
— Sigmoidoscopy, a procedure used to look inside the sigmoid colon and rectum.
— A colonoscopy to examine the large intestine.
Your provider will choose which of these tests are best for you. One test they may choose is a colonoscopy, to help screen for colorectal cancer.
“Although constipation is not a precursor to cancer, bowel habit abnormalities can be a sign of problems. Having an up-to-date colonoscopy can alleviate that concern,” Brull says.
The U.S. Preventive Services Task Force now recommends colonoscopy screening in adults starting at age 45.
More from U.S. News
How Often Should I Poop, and Other Toilet Topics
What to Eat, Drink and Do When You Are Constipated
Best Foods for an Upset Stomach
What Are the Best Natural Laxatives? originally appeared on usnews.com
Update 05/12/23: This piece was previously published at an earlier date and has been updated with new information.
